title: Family environment of bipolar families: a UK study.
abstract: BACKGROUND
  Aspects of family environment (FE) such as family support, organisational structure and levels of conflict can increase risk of Bipolar Disorder (BD) in offspring of BD parents.
  
  
  METHODS
  The family environment of 16 BD and 23 healthy control (HC) families was assessed using the Family Environment Scale (FES). Canonical Correspondence Analysis (CCA) was used to determine the degree of variation in scores on the FES dimensions within each family and a Generalised Linear Modelling (GLM) approach was used to investigate the extent to which scores on the different FES dimensions differed between families.
  
  
  RESULTS
  On the FES, BD families experienced an environment with higher levels of conflict and lower levels of expressiveness, organisation, intellectual-cultural orientation and active-recreational orientation than healthy control families. Differences in FES scores were driven by presence of parental BD and total number of children in the family. However, socio-economic status (SES) was not found to have an effect in this study.
  
  
  CONCLUSIONS
  As an American instrument the FES may not have been sensitive enough to the cultural context of a UK sample. The relatively small sample size used may have limited the statistical power of the study.
  
  
  CONCLUSIONS
  Greater numbers of children have the same effect on levels of conflict as the presence of BD, while SES does not appear to be as important a factor in FE as previously thought. Our results suggest that family based interventions focusing on psychoeducation and improved communication within these families may address issues of conflict, organisation and expressiveness.
authors.affiliation: Newcastle University, UK.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Barron
authors.forename: Aditya
authors.initials: A
authors.lastname: Sharma
authors.forename: James
authors.initials: J
authors.lastname: Le Couteur
authors.forename: Stephen
authors.initials: S
authors.lastname: Rushton
authors.forename: Andrew
authors.initials: A
authors.lastname: Close
authors.forename: Thomas
authors.initials: T
authors.lastname: Kelly
authors.forename: Heinz
authors.initials: H
authors.lastname: Grunze
authors.forename: Ian
authors.initials: I
authors.lastname: Nicol Ferrier
authors.forename: Ann
authors.initials: A
authors.lastname: Le Couteur
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology; D003220:Conflict, Psychological; D005190:Family / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D012931:Social Environment; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Bipolar disorder; FES; Family environment